| Entity Name: | MELBOURNE UNITED LASER VISION ASSOCIATION, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 May 2000 (25 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L00000005294 |
| FEI/EIN Number | 593655115 |
| Address: | 1478 HIGHLAND AVENUE, SUITE A, MELBOURNE, FL, 32935 |
| Mail Address: | 1478 HIGHLAND AVENUE, SUITE A, MELBOURNE, FL, 32935 |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891787446 | 2005-08-19 | 2013-10-21 | 1478 HIGHLAND AVE, SUITE A, MELBOURNE, FL, 329356561, US | 1478 HIGHLAND AVE, SUITE A, MELBOURNE, FL, 329356561, US | |||||||||||||||||||||||||
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| Phone | +1 321-242-2026 |
| Fax | 3212422423 |
Authorized person
| Name | THOMAS C TEATHER |
| Role | MEDICAL DOCTOR |
| Phone | 3212422026 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME66195 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 375920200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Teather Thomas C | Agent | 1478 Highland Ave, MELBOURNE, FL, 32935 |
| Name | Role | Address |
|---|---|---|
| TEATHER THOMAS C | Manager | 1478 HIGHLAND AVENUE, SUITE A, MELBOURNE, FL, 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-13 | Teather, Thomas C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-13 | 1478 Highland Ave, SUITE A, MELBOURNE, FL 32935 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-19 | 1478 HIGHLAND AVENUE, SUITE A, MELBOURNE, FL 32935 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-19 | 1478 HIGHLAND AVENUE, SUITE A, MELBOURNE, FL 32935 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-03-27 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-03 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-04-23 |
| ANNUAL REPORT | 2014-03-25 |
| ANNUAL REPORT | 2013-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
